Tonsillectomy

The tonsils are lymph tissues found in the back of the throat. If your child has frequent throat infections, snoring, or breathing problems, the tonsils may need to be removed. This surgery is called a tonsillectomy. It may be done alone or with another surgery (adenoidectomy, ear tube insertion or sinus surgery). Your child’s treatment plan will depend on the reason for their tonsillectomy.

Having a Tonsillectomy:

• A tonsillectomy is done in the operating room. Your child will receive anesthesia to keep him asleep and comfortable during the surgery.
• The surgery usually takes about an hour.
• Most children will spend several hours in the hospital after surgery. Some children will spend the night, depending on their age and medical history. Your child’s doctor will discuss this with you.

What to expect in the Recovery Room/Post-Anesthesia Care Unit (PACU):

• Your child will have an IV when they wake up in the Recovery Room/PACU. The IV allows us to give your child hydration, and pain medications when needed. For some children, the doctor may also order antibiotics and steroids.
• Your child may be sleepy and/or upset when you arrive in the recovery room.
• There may be small amounts of bloody drainage from your child’s nose or mouth after surgery. This is normal.
• Your child will have a sore throat. The recovery room nurse will treat your child’s pain appropriately. This could include IV pain medication, pain medication taken by mouth or other comfort measures as needed.
• It is very important for your child to drink fluids after surgery as this will make them more comfortable and will aid in the healing process. Please encourage cool liquids and soft, bland foods. It is best to avoid foods that are salty, spicy or have a sharp edge.
• Snoring may not stop until the swelling from surgery is resolved. There may be a nasal quality to your child’s voice. This is normal and may last for several weeks.
• Your child may have some nausea. This is normal and may be related to swallowing a small amount of blood or from the anesthesia.

Home care:

• Raw white areas will appear where the tonsils were removed. These are like scabs and will go away in about two weeks. Your child may also have bad breath for up to 2 weeks. This is normal and will also go away.
• Prescriptions for pain medicine and/or antibiotics may be given by your child’s surgeon. Controlling pain will help your child drink and rest the first couple days after the surgery. Your child’s doctor may also recommend a non-prescription pain medicine such as acetaminophen or ibuprofen. Use these as directed and avoid other over the counter medications that may also contain acetaminophen or ibuprofen. Do NOT use aspirin (aspirin should never be used in children unless prescribed by a physician).
• Your child may experience some ear pain for as long as two weeks after surgery. This pain is “referred pain” from the tonsil area and does not necessarily mean that anything is wrong with the ears.
• It is not unusual for your child to have a low grade fever (temperature of between 98.6- 100°F) during the first post-operative week. If the temperature goes above 102°F, call your child’s doctor’s office.
• Your child should try to not vigorously blow his/her nose or clear the throat for the first week or two after surgery.

Diet:

• It is very important for your child to drink plenty of fluids.
• Additional diet recommendations will be made by your child’s physician.

Activity:

• Limit play to quiet play for at least 3 days following the surgery and allow plenty of time for rest.
• Your child’s return to normal activities and school will be determined by his or her physician. Notes for school and physical education can be given, please ask your recovery room/PACU nurse.

Call the doctor if:

• Your child has a fever greater than 102°F, bleeding from the mouth or nose, signs and symptoms of dehydration, or pain unrelieved by medication.
• Uncontrolled nausea and vomiting.
• Any additional questions or concerns.

Follow-Up:

• Follow up appointments are scheduled by the doctor’s office. If you have any questions, please call the phone number provided on your discharge paperwork.
• Check with your child’s surgeon before making plans to go out of town during the first two weeks after surgery.